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May 25, 2006

Indonesia puts villagers on home quarantine

by Sam Savage

JAKARTA (Reuters) - Health experts have asked 33 people in
a remote Indonesian village to quarantine themselves at home
after the H5N1 bird flu virus killed as many as seven members
of a family there earlier this month.

Epidemiologists have failed to track down the source of
infection in Kubu Simbelang village in north Sumatra and the
World Health Organization said this week limited human-to-human
transmission between family members might have occurred.

"There are 33 people identified as close contacts. We've
asked them to observe home quarantine. That's something they
are willing to do to protect themselves and their families,"
said Dick Thompson, spokesman for the WHO.

Meanwhile, local tests have confirmed an Indonesian child
from the city of Bandung died of bird flu, a senior health
ministry official said on Thursday.

Local results on bird flu cases are not considered
definitive and need confirmation from the World Health
Organization.

I Nyoman Kandun, director-general of communicable disease
control, told Reuters local tests have found two siblings
admitted to hospital earlier this week in the West Java capital
of Bandung was a positive H5N1 case.

"The two of them are now positive," he told Reuters in a
telephone text message.

The younger sibling, a 10-year old girl, died on Tuesday.
The condition of the 18-year-old brother was not immediately
clear.

But attention is still primarily focused on the Sumatran
cluster, the largest to date.

Tests on samples taken from chickens, ducks and pigs --
animals that are most susceptible to the virus -- in Kubu
Simbelang village and another nearby area have proven
inconclusive.

Fuelling the suspicion hanging over person-to-person
transmission is the unusually long time lag of 15 days between
the first and the last person in the cluster falling ill.

The incubation period for the H5N1 is usually no more than
seven days and if the family had been exposed to the same
source, they would all have fallen ill at about the same time.

"You want to look at the dates of onset of the disease. If
they are close together they may have had the same exposure,"
Thompson said.

The WHO has, however stressed that even if human-to-human
transmission did occur, it was in a very limited way and the
infection has not spread beyond the family cluster. In
addition, scientific evidence has shown the virus has not
mutated into one that can be easily passed among people.

H5N1 remains difficult for humans to catch, but experts
fear it could evolve into a form passes easily from human to
human, causing a pandemic that could kill millions.